Jesse C Christensen1, Paul W Kline2, Amanda M Murray3, Cory L Christiansen4. 1. University of Utah, Department of Physical Therapy and Athletic Training, United States of America; Veterans Affairs Salt Lake City Health Care System, United States of America; University of Colorado, Department of Physical Medicine and Rehabilitation, United States of America; Eastern Colorado Geriatric Research Education and Clinical Center, United States of America. Electronic address: jesse.christensen@hsc.utah.edu. 2. University of Colorado, Department of Physical Medicine and Rehabilitation, United States of America; High Point University, Department of Physical Therapy, United States of America. Electronic address: pkline@highpoint.edu. 3. University of Toledo, School of Exercise & Rehabilitation Sciences, United States of America. Electronic address: amanda.murray2@utoledo.edu. 4. University of Colorado, Department of Physical Medicine and Rehabilitation, United States of America; Eastern Colorado Geriatric Research Education and Clinical Center, United States of America. Electronic address: cory.christiansen@ucdenver.edu.
Abstract
BACKGROUND: Movement asymmetries between lower limbs are commonly exhibited by adults after transtibial amputation. However, the degree of movement asymmetry between low- and high-demand functional tasks remains unknown. METHODS: Kinematic and kinetic data were collected during overground walking (low-demand) and step ascent (high-demand) tasks for two groups: 1) persons with transtibial amputation and 2) healthy matched peers. Analysis of covariance was used to compare sagittal-plane peak knee moment and joint angle (primary) and hip and ankle moments and joint angles, vertical ground reaction force and impulse (secondary). FINDINGS: Within transtibial amputation group comparisons showed significantly greater between-limb asymmetry in peak knee moment (p < .01), vertical impulse (p < .01), peak vertical ground reaction force (p = .05), peak ankle angle (p < .01) and peak ankle moment (p < .01) with the step ascent task compared to overground walking. The transtibial amputation group had greater between-limb asymmetry during step ascent in peak knee moment (p < .01), vertical impulse (p < .01), peak vertical ground reaction force (p = .04) and peak ankle angle (p < .01) than healthy matched peers. During overground walking, the transtibial amputation group had greater between-limb asymmetry in peak vertical impulse (p = .05) and peak ankle moment (p < .01) than healthy matched peers. INTERPRETATION: Movement asymmetry is increased during step ascent compared to overground walking for adults with transtibial amputation. While the restoration of overground walking is the focus of post-amputation rehabilitation and prosthetic design, higher demand tasks should also be considered to maximize mobility for adults with transtibial amputation. Published by Elsevier Ltd.
BACKGROUND: Movement asymmetries between lower limbs are commonly exhibited by adults after transtibial amputation. However, the degree of movement asymmetry between low- and high-demand functional tasks remains unknown. METHODS: Kinematic and kinetic data were collected during overground walking (low-demand) and step ascent (high-demand) tasks for two groups: 1) persons with transtibial amputation and 2) healthy matched peers. Analysis of covariance was used to compare sagittal-plane peak knee moment and joint angle (primary) and hip and ankle moments and joint angles, vertical ground reaction force and impulse (secondary). FINDINGS: Within transtibial amputation group comparisons showed significantly greater between-limb asymmetry in peak knee moment (p < .01), vertical impulse (p < .01), peak vertical ground reaction force (p = .05), peak ankle angle (p < .01) and peak ankle moment (p < .01) with the step ascent task compared to overground walking. The transtibial amputation group had greater between-limb asymmetry during step ascent in peak knee moment (p < .01), vertical impulse (p < .01), peak vertical ground reaction force (p = .04) and peak ankle angle (p < .01) than healthy matched peers. During overground walking, the transtibial amputation group had greater between-limb asymmetry in peak vertical impulse (p = .05) and peak ankle moment (p < .01) than healthy matched peers. INTERPRETATION: Movement asymmetry is increased during step ascent compared to overground walking for adults with transtibial amputation. While the restoration of overground walking is the focus of post-amputation rehabilitation and prosthetic design, higher demand tasks should also be considered to maximize mobility for adults with transtibial amputation. Published by Elsevier Ltd.
Authors: Abbie E Ferris; Jennifer M Aldridge; Christopher A Rábago; Jason M Wilken Journal: Arch Phys Med Rehabil Date: 2012-06-22 Impact factor: 3.966